Related Experiment Videos
Glucocorticosteroids for primary biliary cirrhosis
M Prince1, E Christensen, C Gluud
1Centre for Liver Research, 5th floor, William Leech Building, Framlington Place, Newcastle, UK, NE3 IUD. martin.prince@ncl.ac.uk
The Cochrane Database of Systematic Reviews
|April 23, 2005
Summary
Glucocorticosteroids show no mortality benefit for primary biliary cirrhosis patients. While improving liver markers, they significantly increase adverse events and reduce bone density, warranting further research.
Area of Science:
- Hepatology
- Autoimmune Diseases
- Clinical Trials
Background:
- Primary biliary cirrhosis (PBC) is a chronic, autoimmune cholestatic liver disease.
- PBC involves progressive destruction of intrahepatic bile ducts, potentially leading to cirrhosis and liver failure.
- Glucocorticosteroids, potent immunosuppressants, may influence PBC progression but carry risks like osteoporosis.
Purpose of the Study:
- To systematically evaluate the efficacy and safety of glucocorticosteroids versus placebo in PBC patients.
- To assess the beneficial and harmful effects of glucocorticosteroid treatment for primary biliary cirrhosis.
Main Methods:
- A comprehensive literature search of multiple databases (Cochrane Hepato-Biliary, MEDLINE, EMBASE) was conducted up to June 2004.
- Included were randomized clinical trials comparing glucocorticosteroids with placebo or no intervention in diagnosed PBC patients.
- Trial quality was assessed, and intention-to-treat analyses were performed.
Main Results:
- Two small, underpowered trials were identified, with unclear allocation concealment.
- Glucocorticosteroids did not significantly reduce mortality (OR 0.42, 95% CI 0.10-1.76).
- Significant increases in adverse events (OR 8.99, 95% CI 2.15-37.58) and bone mineral density loss (-2.84%) were observed with glucocorticosteroids.
Conclusions:
- Insufficient evidence exists to support or refute the use of glucocorticosteroids in primary biliary cirrhosis.
- Larger, prospective randomized clinical trials are recommended to definitively assess glucocorticosteroid therapy in PBC.